Individual
DR. JESSICA LYNN BRUMM-LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LPC, NCSP
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2932
(414) 266-3735
Mailing address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2932
(414) 266-3735
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3263-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699089490
—
WI
05
—
47037660631
—
NE
Enumeration date
08/04/2010
Last updated
05/05/2023
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